Tuberculosis in House Staff: A Decision Analysis Comparing the Tuberculin Screening Strategy with the BCG Vaccination
- 1 March 1991
- journal article
- research article
- Published by American Thoracic Society in American Review of Respiratory Disease
- Vol. 143 (3), 490-495
- https://doi.org/10.1164/ajrccm/143.3.490
Abstract
The BCG vaccination is not recommended for health-care workers in the United States. The current strategy against tuberculosis in tuberculin-negative house staff is an annual tuberculin screening test followed by chemoprophylaxis with isoniazid for a positive result. We performed a decision analysis that unequivocally concluded that the BCG vaccination leads to fewer cases of tuberculosis in this population over a 10-yr period. The BCG vaccine requires only an efficacy rate of at least 13.1% to prevent more cases of tuberculosis than the current strategy. This threshold value is independent of the annual tuberculin conversion rate. This study provides a framework, based on the best information in the literature, on which a well-informed decision regarding tuberculosis prevention can be made. Therefore, this analysis demonstrates that the BCG vaccine should be considered for tuberculin-negative house officers and medical students working in high risk areas of the United States.Keywords
This publication has 10 references indexed in Scilit:
- Occupational Tuberculous Infections among Pulmonary Physicians in TrainingAmerican Review of Respiratory Disease, 1990
- Tuberculosis in the United StatesPublished by American Medical Association (AMA) ,1989
- Decision AnalysisNew England Journal of Medicine, 1987
- Risk of Tuberculous Infection Among House Staff in an Urban Teaching HospitalSouthern Medical Journal, 1985
- The BCG ControversyJAMA, 1983
- Should Young Adults with a Positive Tuberculin Test Take Isoniazid?Annals of Internal Medicine, 1981
- The Epidemiology of Tuberculosis in PhysiciansPublished by American Medical Association (AMA) ,1979
- The utility of different health states as perceived by the general publicJournal of Chronic Diseases, 1978
- Isoniazid HepatitisAnnals of Internal Medicine, 1973
- The Value of the Tuberculin Skin Test as a Screening Test for Tuberculosis among BCG-Vaccinated ChildrenPediatrics, 1965